Provider Demographics
NPI:1942399282
Name:COHEN, WARREN ANDREW
Entity Type:Individual
Prefix:MR
First Name:WARREN
Middle Name:ANDREW
Last Name:COHEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 W RAILROAD AVE
Mailing Address - Street 2:
Mailing Address - City:GARNERVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10923-1243
Mailing Address - Country:US
Mailing Address - Phone:845-424-5075
Mailing Address - Fax:845-429-5676
Practice Address - Street 1:150 WEST RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:GARNERVILLE
Practice Address - State:NY
Practice Address - Zip Code:10923
Practice Address - Country:US
Practice Address - Phone:845-429-5075
Practice Address - Fax:845-429-5676
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30746183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist